2018 Affordability Percentage Released

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Jan 10, 2017

HR360, Inc.

December 22, 2016

2018 Individual Mandate Required Contribution Percentage Released

​Certain Special Enrollment Periods Also Codified

The U.S. Department of Health and Human Services (HHS) has released a final rule which establishes the required contribution percentage under the individual mandate for 2018 and codifies certain special enrollment periods.

2018 Required Contribution Percentage

The Affordable Care Act's "​individual mandate" provision requires every individual to have minimum essential coverage for each month, qualify for an exemption, or make a penalty payment when filing his or her federal income tax return. One such exemption applies when the amount that an individual would be required to pay for minimum essential coverage (the required contribution) exceeds a particular percentage of his or her actual household income for a taxable year (the required contribution percentage).

Under the final rule, the required contribution percentage under the individual mandate for 2018 is 8.05%, a decrease from 8.16% for 2017.

Special Enrollment Periods

In addition, HHS codified special enrollment periods for the following consumers who apply for coverage on the Health Insurance Marketplace (among others):

​Individuals and their dependents who apply for coverage and are later determined to be ineligible for Medicaid or CHIP;

Individuals who resolve a ​data matching issue following the expiration of an inconsistency period; and

Victims of domestic abuse or spousal abandonment and their dependents who seek to apply for coverage apart from the perpetrator of the abuse or abandonment.

While these special enrollment periods have previously been available to consumers, the agency sought codification in order to ensure the rules are clear and to limit potential abuse. Click ​here to read the final rule in its entirety.

For questions, please ​contact a member of your b&p Sales Team - 888.722.3373.